局部晚期胰腺癌容积旋转调强与五野调强放疗的剂量学比较

doi:10.13481/j.1671-587x.20170230

吉林大学学报(医学版) ›› 2017, Vol. 43 ›› Issue (02): 365-368.doi: 10.13481/j.1671-587x.20170230

局部晚期胰腺癌容积旋转调强与五野调强放疗的剂量学比较

孙小梅, 夏文明, 姜新, 陈祥, 李涛, 曲雅勤

吉林大学第一医院放疗科, 吉林长春 130021

收稿日期:2016-12-23 出版日期:2017-03-28 发布日期:2017-03-31
通讯作者: 曲雅勤,教授,博士研究生导师(Tel:0431-88782488,E-mail:quyaqin52@163.com) E-mail:quyaqin52@163.com
作者简介:孙小梅(1991-),女,山东省济宁市人,在读医学硕士,主要从事恶性肿瘤放射治疗增敏方面的研究。
基金资助:
国家自然科学基金资助课题（81372929）

Comparison of dosimetry between RapidArc and 5F-IMRT in treatment of locally advanced pancreatic carcinoma

SUN Xiaomei, XIA Wenming, JIANG Xin, CHEN Xiang, LI Tao, QU Yaqin

Department of Radiotherapy, First Hospital, Jilin University, Changchun 130021, China

Received:2016-12-23 Online:2017-03-28 Published:2017-03-31

摘要/Abstract

摘要： 目的：探讨容积旋转调强放射治疗（RapidArc）与五野调强放射治疗（5F-IMRT）在局部晚期胰腺癌治疗中剂量分布特点，为临床选择合适的照射技术提供参考。方法：选择局部晚期胰腺癌患者10例，行CT模拟定位，并勾画靶区及危及器官。分别对每例患者设计RapidArc计划和5F-IMRT计划，评估靶区及危及器官的剂量学差异。结果：RapidArc计划的靶区适形指数（CI）优于5F-IMRT计划（P=0.01），其靶区均匀性指数（HI）比较差异无统计学意义（P>0.05）；RapidArc计划中脊髓最大剂量（D_max）低于5F-IMRT计划（P=0.005）；RapidArc计划中胃平均剂量（D_mean）低于5F-IMRT计划（P=0.019）；5F-IMRT计划中肾脏V20低于RapidArc计划（P=0.043）；RapidArc计划中小肠平均剂量（D_mean）低于5F-IMRT计划（P=0.011）；RapidArc计划中小肠V10低于5F-IMRT计划（P=0.015）；RapidArc计划中小肠V20低于5F-IMRT计划（P=0.14）；RapidArc计划较5F-IMRT计划的平均机器跳数（MU）减少了18.0%，治疗时间缩短了70.3%。RapidArc计划肝脏和肾脏等危及器官受量接近或略小于5F-IMRT计划。结论：RapidArc计划的主要优势为靶区适形度高，可减少MU和缩短治疗时间，能更好地降低危及器官受量。临床上建议设计RapidArc计划。

关键词: 适形指数, 胰腺肿瘤, 容积旋转调强放射治疗, 五野调强放射治疗

Abstract: Objective: To explore the dose distribution characteristics between RapidArc and five-field intensity modulated radiotherapy(5F-IMRT) plans in the treatment of locally advanced pancreatic carcinoma,and to provide reference for selecting the appropriate radiation technique in clinic. Methods: Ten patients with locally advanced pancreatic carcinoma were selected.The patients were scanned by simulation CT, and the targets and organs at risk were contoured. RapidArc plan and 5F-IMRT plan were designed respectively. The treatment time and the differences of dose distribution in the targets and organs at risk of RapidArc and 5F-IMRT plans were compared. Results: The conformal index (CI) of RapidArc plan was superior than that of 5F-IMRT plan(P=0.01).The homogeneity index (HI) of targets were similar between two plans (P>0.05). RapidArc plan decreased the maximum dose (D_max) of the spinal cord(P=0.005); RapidArc plan decreased the mean dose(D_mean) of stomach(P=0.019); 5F-IMRT plan decreased the V20 of kidney(P=0.043);RapidArc plan decreased the mean dose(D_mean) of small intestine(P=0.011).The small intestine V10 and V20 of RapidArc plan were lower than those of 5F-IMRT plan(P=0.015,P=0.14); the monitor unit (MU) of RapidArc plan was significantly lower than that of 5F-IMRT plan,with a 18% reduction from the MU level of the latter one,and the treatment time was reduced by 70.3%. RapidArc plan had the smaller doses at liver and kidney compared with 5F-IMRT plan. Conclusion: For the patients with locally advanced pancreatic carcinoma,RapidArc plan has higher CI. RapidArc plan shows the advantages in the protection of organs. Compared with 5F-IMRT,RapidArc plan has less treatment time and significantly improves the curative efficiency.In clinic, the RapidArc plan is recommended.

Key words: pancreatic neoplasms, RapidArc, five-field intensity modulated radiotherapy, conformal index

中图分类号:

R735.9

孙小梅, 夏文明, 姜新, 陈祥, 李涛, 曲雅勤. 局部晚期胰腺癌容积旋转调强与五野调强放疗的剂量学比较[J]. 吉林大学学报(医学版), 2017, 43(02): 365-368.

SUN Xiaomei, XIA Wenming, JIANG Xin, CHEN Xiang, LI Tao, QU Yaqin. Comparison of dosimetry between RapidArc and 5F-IMRT in treatment of locally advanced pancreatic carcinoma[J]. Journal of Jilin University Medicine Edition, 2017, 43(02): 365-368.

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局部晚期胰腺癌容积旋转调强与五野调强放疗的剂量学比较

Comparison of dosimetry between RapidArc and 5F-IMRT in treatment of locally advanced pancreatic carcinoma

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